Sonographic characteristics of presumptively normal main axillary and superficial cervical lymph nodes in dogs

Objective-To evaluate the B-mode and Doppler ultrasonographic appearance of presumptively normal main axillary and large superficial cervical lymph nodes (MALNs and SCLNs, respectively) in adult dogs. Animals-51 healthy adult dogs (data from 1 dog were not analyzed). Procedures-For each dog, weight, distance from the cranial aspect of the first sternebra to the caudal aspect of the left ischiatic tuberosity, and thoracic height and width at the level of the xiphoid process were recorded. Via B-mode and Doppler ultrasonography, echogenic characteristics, size in relation to body size and weight, and vascular supply of the MALNs and the SCLNs were evaluated (1 SCLN in 1 dog was not ultrasonographically visible). Results-Most MALNs were clearly margined, solitary, and ovoid; echopatterns were homogenous or cortical and hypo- to isoechoic, compared with surrounding soft tissues. Size measurements of MALNs correlated with dogs' body length, thoracic width and height, and body weight. Most SCLNs were clearly margined, fusiform, and hypoechoic (compared with surrounding soft tissues) with a cortical or homogenous echopattern. Size measurements of SCLNs correlated with dogs' body length, thoracic width and height, and body weight. In 50 of the 100 MALNs, an intranodal vascular supply was detected; in contrast, an intranodal vascular supply in SCLNs was detected infrequently. Conclusions and Clinical Relevance-Results indicated that, in dogs, anatomically separate lymph nodes have different echogenic and vascular characteristics; body size (skeletal length, height, and width), along with body weight, were correlated with sizes of presumptively normal MALNs and SCLNs.     

Spectral waveform analysis of major arteries in conscious dogs by Doppler ultrasonography

Normal values of arterial blood flow velocity and waveforms in major arteries of 10 healthy conscious Beagle dogs were determined using Doppler ultrasonography. Peak systolic, early diastolic, and end-diastolic velocities of the basilar artery, common carotid artery, abdominal aorta, external iliac artery, femoral artery, and peak ejection velocity of the valvular aorta were evaluated. Pulsatility index (PI) of the basilar artery and blood pressure were recorded. All arteries had a high-resistance flow pattern with triphasic flow velocity except the basilar artery, which had a low-resistance pattern. Mean peak systolic velocities of the basilar artery, common carotid artery, abdominal aorta, external iliac artery, and femoral artery were 72 +/- 19, 115 +/- 17, 121 +/- 24, 105 +/- 25, and 110 +/- 17 cm/s, respectively. The PI of the basilar artery and peak ejection velocity of the valvular aorta were 1.37 +/- 0.13 and 96 +/- 16 cm/s, respectively. Mean systolic and diastolic blood pressures were 137 +/- 13 and 78 +/- 15 mmHg, respectively. Present findings may be used as references in future studies on vascular diseases and hemodynamics in dogs.     

Comparison of B-mode and Doppler ultrasonographic findings with histologic features of benign and malignant superficial lymph nodes in dogs

OBJECTIVE: To compare and correlate B-mode and color Doppler ultrasonographic characteristics with histopathologic findings of benign and malignant superficial lymph nodes in dogs. STUDY POPULATION: 50 superficial lymph nodes that were normal, abnormally large on physical examination, or represented regional lymph nodes draining an area of suspected primary malignancy in 30 dogs. PROCEDURES: Before excision, lymph nodes were evaluated via B-mode and color Doppler ultrasonography to assess size, echogenicity, presence of a hilus, acoustic transmission, and vascular flow. Formalin-fixed, paraffin-embedded tissue sections of excised lymph nodes were stained with H&E and examined for the presence and extent of necrosis, fibrosis, fat, metastases, and tissue heterogeneity. To assess vascularity, the number and distribution of vessels stained by the Verhoeff van Gieson technique were recorded. RESULTS: In superficial lymph nodes, a varied echogenicity corresponded to tissue heterogeneity. The ultrasonographic detection of a hilus was associated with the presence of fibrous tissue, fat, or both in the hilar region. Acoustic enhancement corresponded to presence of areas of intranodal necrosis. There was significant correlation between both the distribution and the number of vessels detected via ultrasonography and that detected by histopathology. The amount of flow estimated via ultrasonography was typically higher than that estimated via histologic examination. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that histopathologic changes in canine lymph nodes have associated ultrasonographic changes and suggest that lymph node ultrasonography has an important role in the evaluation of lymph nodes in dogs in general and in dogs with neoplastic disease in particular.     

Ultrasonographic appearance of the superficial supramammary lymph nodes in lactating dairy cattle

The superficial supramammary lymph nodes of 54 lactating dairy cows were examined ultrasonographically with a 7.5 MHz linear transducer; each node was measured in two planes within 24 hours of recording the milk somatic cell count. In most cows, the nodes were well demarcated from the surrounding tissue. The parenchyma of the nodes ranged from hypoechoic to anechoic, with a central bright hyperechoic area, and a thin hyperechoic line surrounded the nodes. The size of the nodes varied, but their internal architecture remained relatively consistent. Their mean length was 7.4 cm (range 3.5 to 15 cm) and their mean depth was 2.5 cm (range 1.2 to 5.7 cm). They were significantly larger in cows with more lactations (P<0.05), but there were no correlations between their size and either the time calved or the milk somatic cell count. The lymph nodes on sides which were positive in a California milk test were significantly larger than those on sides which were negative (P<0.05).     

Assessment of renal blood flow in dogs: analysis of 131I-hippuran blood clearance in healthy dogs and in dogs with proteinuria

In 30 clinically healthy dogs (weights 7.5 to 57 kg) and in 41 proteinuric dogs the 131I-hippuran blood disappearance curve after single injection was determined (0 to 90 minutes), described by a bi-exponential function and analysed according to a two compartment model. The dependence of the blood clearance (C), representing an effective renal blood flow, on the bodyweight (W) (kg) could be described with both a linear function (C = 61 + 13.2 W ml min-1) and a power function (C = 30.56 W0.79 ml min-1) in the healthy dogs. The results of the regression between blood clearance and bodyweight were reproducible (r = 0.92, n = 10 residual error 12 per cent, P less than 0.01).     

Comparison of arterial pressure waveform analysis with the lithium dilution technique to monitor cardiac output in anesthetized dogs

OBJECTIVE: To assess agreement between arterial pressure waveform-derived cardiac output (PCO) and lithium dilution cardiac output (LiDCO) systems in measurements of various levels of cardiac output (CO) induced by changes in anesthetic depth and administration of inotropic drugs in dogs. ANIMALS: 6 healthy dogs. PROCEDURE: Dogs were anesthetized on 2 occasions separated by at least 5 days. Inotropic drug administration (dopamine or dobutamine) was randomly assigned in a crossover manner. Following initial calibration of PCO measurements with a LiDCO measurement, 4 randomly assigned treatments were administered to vary CO; subsequently, concurrent pairs of PCO and LiDCO measurements were obtained. Treatments included a light plane of anesthesia, deep plane of anesthesia, continuous infusion of an inotropic drug (rate adjusted to achieve a mean arterial pressure of 65 to 80 mm Hg), and continuous infusion of an inotropic drug (7 microg/kg/min). RESULTS: Significant differences in PCO and LiDCO measurements were found during deep planes of anesthesia and with dopamine infusions but not during the light plane of anesthesia or with dobutamine infusions. The PCO system provided higher CO measurements than the LiDCO system during deep planes of anesthesia but lower CO measurements during dopamine infusions. CONCLUSIONS AND CLINICAL RELEVANCE: The PCO system tracked changes in CO in a similar direction as the LiDCO system. The PCO system provided better agreement with LiDCO measurements over time when hemodynamic conditions were similar to those during initial calibration. Recalibration of the PCO system is recommended when hemodynamic conditions or pressure waveforms are altered appreciably.     

Cytochemical staining characteristics of lymph nodes from normal and lymphoma-affected dogs

Frozen sections and imprint smears were used to evaluate the presence and pattern of cytochemical staining reactions in the B- and T-cell regions of lymph nodes from normal dogs and dogs with lymphoma. Staining procedures evaluated included peroxidase (PER), Sudan black B (SBB), naphthol AS-D chloroacetate esterase (CAE), alpha-naphthyl butyrate esterase (NBE), acid phosphatase (ACP), and leukocyte alkaline phosphatase (LAP). In normal lymph nodes, macrophages and some lymphocytes within the interfollicular (T-cell) region and medulla stained positive with ACP and NBE. Smaller numbers of macrophages also occurred sporadically within the germinal follicles. Cells positive for PER, SBB, and CAE were scattered infrequently throughout all regions of the normal lymph node, consistent with granulocytes and mast cells. The LAP stained cells were predominantly and prominently located within the mantle zone of secondary follicles and to a much lesser extent within the germinal centers, compatible with B-cell lymphocytes derived from follicular center cells. Of the 12 dogs with lymphoma, 7 cases (4 immunoblastic, 2 large noncleaved, 1 small noncleaved) stained diffusely positive with LAP, 4 cases (all lymphoblastic) had numerous focally positive lymphocytes using ACP and NBE, and 1 case (immunoblastic) did not stain positive with any of the cytochemical reactions. Cytochemical staining of canine lymph nodes with NBE, ACP, and LAP proved useful in distinguishing between B- or T-cell regions and detecting different cell types of canine lymphoma.     

Radiographic characterization of enlarged sternal lymph nodes in 71 dogs and 13 cats

In this retrospective study, radiographically enlarged sternal lymph nodes (LNs) were evaluated in 71 dogs and 13 cats for average size, location, and most representative radiographic view. Concurrent clinical diagnoses were also noted and grouped into one of three following categories: neoplastic, inflammatory, or hematologic. There were no statistically significant differences in LN size between lateral views within each species. Enlarged sternal LNs were more cranially positioned in dogs than cats. No statistical difference was noted between right and left laterals, as to on which projection the enlarged sterna lymph nodes was seen best. Neoplastic disease (78.9%) was the most prevalent condition seen in association with LN enlargement in dogs, followed by primary infectious or inflammatory diseases (14.1%) and various hematologic conditions (7.0%). In cats, neoplasia was also most common (69.2%), followed by inflammatory diseases (30.8%). No hematologic conditions were noted in cats. The most common etiologic agent seen concurrently with enlarged sternal LNs in both dogs (33.8%) and cats (38.5%) was malignant lymphoma. The results of this study provide a clinically useful representation of the average size and location of radiographically enlarged sternal LNs for dogs and cats. The diseases represented demonstrate the wide spectrum of potential causes of sternal lymphadenopathy.     

Pathways of lymph flow from superficial tissues in the legs of horses

Pathways of peripheral lymph flow from the legs in horses were studied with casts, and with light and electron microscopic techniques. Although lymph nodes in horses occur in large groups, each lymph vessel draining from the periphery appeared to terminate on a single node within a group. The larger branches of each vessel divided either on the node surface or after penetrating into the node, and 25 to 60 terminal afferent vessels entered either the subcapsular, medullary or trabecular sinuses. Numerous initial efferent lymphatics arose either within the medulla, or at its surface, and they often coalesced to form an anastomosing network on the node surface. Almost all of the one to four efferent lymphatics that left the vicinity of the node terminated on other nodes, usually within more centrally placed groups. This arrangement may aid in the amplification and propagation of immune responses initiated in primary nodes.     

Minimal residual disease in lymph nodes after achievement of complete remission predicts time to relapse in dogs with large B‐cell lymphoma

Most dogs with large B‐cell lymphoma (LBCL) that undergo chemotherapy and achieve clinical complete remission (CR) eventually relapse. However, time to relapse (TTR) is unpredictable. The aims of this prospective study were to assess the influence of post‐chemotherapy lymph node (LN) infiltration by large CD21+ cells using flow cytometry (FC) on TTR, and to establish a cut‐off value of prognostic significance. Dogs with newly‐diagnosed, completely staged LBCL in CR after treatment were enrolled. Minimal residual disease (MRD) analysis by FC was performed on LN aspirates. TTR was calculated between MRD and relapse. Thirty‐one dogs were enrolled: 4% had stage V disease, and diffuse large B‐cell lymphoma was the most common histotype (74%). Based on LN infiltration at MRD evaluation, three groups were created: (a) acellular samples, (b) ≤0.5% infiltration and (c) >0.5% infiltration. Overall median TTR was 154 days (range, 31‐1974): 22 (71%) dogs relapsed during the study period, whereas 9 (29%) dogs did not. The difference among the three groups was significant (P = 0.042 log‐rank test): median TTR was not reached for dogs with LN infiltration ≤0.5% (range, 195‐429 days), 164 days (range 63‐1974) for dogs with acellular LN samples, and 118 days (range, 31‐232) for dogs with LN infiltration >0.5%. These results demonstrate that MRD assessment by FC on LN aspirates in dogs with LBCL in clinical CR predicts TTR. LN infiltration by >0.5% large CD21+ cells after treatment is an unfavourable prognostic factor.     

犬腹腔镜结肠固定术对犬动脉血气的影响

在进行犬腹腔镜结肠固定术的过程中,分别于麻醉前、术中1Omin、术中3Omin、术中5Omin和术后即刻抽取犬股动脉血,监测动脉血酸碱度（pH）值、二氧化碳分压（PacO2）、氧分压（PaO2）和氧饱和度（SatO2）,以评价犬腹腔镜手术术对犬动脉血气的影响。试验结果显示,腹腔镜结肠固定术使犬动脉血pH在术中下降极显著,PCO2先升高后降低,PO2和satO2先降低后升高,但是术后即刻pH、PaCO2、PaO2和satO2都基本恢复到正常,与麻醉前相比没有显著差异。本试验表明犬在腹腔镜结肠固定术中虽然不会发生低氧血症,但是会出现暂时性的呼吸性酸中毒,因此在犬结肠固定术过程中应该注意对血气进行监护。     

Comparison of ultrasonic Doppler flow monitor,oscillometric, and direct arterial blood pressure measurements in ill dogs

Objective – To compare blood pressure measurements obtained via ultrasonic Doppler flow monitor (DOP) and 2 oscillometric noninvasive blood pressure monitors (CAR and PAS) to invasive blood pressure (IBP) in hospitalized, conscious dogs with a range of blood pressures. Design – Prospective clinical study. Setting – University teaching hospital. Animals – Eleven client‐owned dogs aged between 4 months and 11.5 years (median 6 y), and weighing between 5.8 and 37.5 kg (median 30.2 kg). Interventions – Blood pressure measurement. Measurements and Main Results – Three consecutive measurements of systolic, diastolic, and mean arterial pressure (MAP) were recorded for each of the 3 indirect devices (only systolic for DOP), along with concurrent IBP measurements. The data were categorized into 3 groups: hypotensive (direct MAP<80 mm Hg), normotensive (80 mm Hg≤direct MAP≥100 mm Hg), and hypertensive (direct MAP>100 mm Hg). Each indirect method was compared with the corresponding direct arterial pressure using the Bland‐Altman method. Within the hypotensive group, each indirect method overestimated the corresponding IBP. Within the normotensive group all indirect systolic measurements and the PAS diastolic measurements underestimated the corresponding IBP. The remaining indirect measurements overestimated the corresponding IBP. Within the hypertensive group, DOP and CAR systolic measurements underestimated the corresponding IBP, and the remaining indirect measurements overestimated the corresponding IBP. In hypertensive dogs oscillometric systolic measurements were more accurate than MAP. In hypotensive dogs MAP measurements were more accurate than systolic measurements. All indirect measurements were most accurate in hypertensive dogs. Conclusions – The noninvasive blood pressure monitors in our study did not meet the validation standards set in human medicine. However, CAR diastolic and MAP measurements within the normotensive group, CAR MAP measurements within the hypertensive group, and PAS diastolic measurements in all groups were close to these standards. All indirect measurements showed greater bias during hypotension. Precision was poorer for all indirect systolic measurements than for MAP.     

Comparisons between elastographic stiffness scores for benign versus malignant lymph nodes in dogs and cats

Lymph node evaluation is an important component of oncology staging in dogs and cats, however diagnosis of malignancy currently requires cytology or histopathology. Elastography is an ultrasound technique that allows estimation of tissue stiffness. In people, it has been shown to increase the sensitivity of sonography in detection of metastatic lymph nodes. The objective of this prospective, cross‐sectional study was to determine if elastographic stiffness differs for malignant versus benign canine and feline lymph nodes that were considered abnormal in gray‐scale ultrasound imaging. Animals scheduled for ultrasound‐guided fine needle aspirates of a lymph node at a single center were prospectively enrolled. Elastography was performed by a board‐certified veterinary radiologist (G.S.) prior to tissue sampling. Softness was scored qualitatively as 1–4 (1 = hard; 4 = soft) on an image depicted by a color scale (blue = hard, red = soft). Quantitative analysis was performed using custom‐made software. Fifty‐one lymph nodes were included in the evaluation, 21 had benign and 30 had neoplastic cytology. Benign lymph nodes were softer (median score of 2.5, range 1–4) than malignant lymph nodes (median = 2, range 1–3), and differences were significant in qualitative and quantitative analyses (P < 0.01). Of the lymph nodes with a score of 2 or below (hard), 19/25 (76%) were malignant, of the lymph nodes with a score over 2 (soft), 24/36 (67%) were benign. Findings indicated that elastographic stiffness scores differed between benign and malignant lymph node groups; however overlapping scores for the two groups limited the use of this technique for routine clinical diagnosis of malignancy.